Loss of length

[JakOBson]

From what I’ve been reading, I am under impression that implanting almost inevitably leads to loss of length.

Is that true? Anyone here who managed to recover to full length as it was prior to ED?

[Howling8]

Not always. Dr Perito has some good videos on the subject and can better explain why it may happen. https://peritourology.com/meet-the-penis-episodes/

In my case, injections were working fine I just didn't like the 90 minute hard ons. I was implanted 10/28/21 and started using it by Xmas. At first I was almost the same length but had lost 1/2 to 1 inch of girth. My wife was disappointed at first in its oval shape and smaller size. I worked the Perito exercises and it worked. I now have 95% of my girth back and actually added 1/4 - 1/2 inch over my pre implanted cock. I have great engorgement of the glans and shaft which now finally looks and feels like a real cock per my wife. She said the other night that she thought it was bigger.

[2435tjklAS]

I don't think losing length is expected anymore. It used to be the #1 complaint about implants, but the truth is that is outdated and there's tons of current medical research as well as personal experiences that confirm with use of a VED before and after surgery, losing any dick size should no longer be a concern with getting an implant. In fact, gaining size to get your dick back to the size it was in the good ole days before erectile dysfunction is actually expected, especially with AMS 700 LGX even advertising up to a 25% length increase.

Wrote this in two different posts a while ago and felt like combining the facts here:

Use a VED before surgery. Here's why:

When pre-operative VED is used, SPL could increase by a
mean of 0.80
0.38 cm. In addition, the surgeon is provided
with better opportunity to restore longer penile length that replicates
an appearance more consistent with the patient’s natural
erection. Ease of corporal dilation allows for an appropriate size
cylinder to be inserted, and thus helps to maximize patient satisfaction
post-operatively. There were no negative intraoperative
complications associated with the use of pre-operative VED, and
therefore, if patients have access to it, VEDs can safely be recommended.
Future studies among larger samples will help assess
the long-term outcomes and outline the role of VED as a valuable
intervention prior to PP implantation.

Canguven, O., Talib, R. A., Campbell, J., De Young, L., El Ansari, W., & Al-Ansari, A. (2017). Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology, 5(1), 103–106. https://doi.org/10.1111/andr.12258

Use a VED after surgery too. Here's why:

Penile shortening after inflatable penile prosthesis placement for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18–29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

Antonini, G., De Berardinis, E., Busetto, G. M., Del Giudice, F., Chung, B. I., Conti, S. L., Ferro, M., Musi, G., Fragas, R., De Cobelli, O., Sperduti, I., Gross, M. S., & Perito, P. E. (2020). Postoperative vacuum therapy following AMSTM LGX 700® inflatable penile prosthesis placement: Penile dimension outcomes and overall satisfaction. International Journal of Impotence Research, 32(1), 133–139. https://doi.org/10.1038/s41443-019-0125-z

viewtopic.php?f=6&t=18561&p=169469#p169469

This is how they work:

VED, which are traditionally a closed end plastic cylinder placed over the penis, use negative pressure via a battery or hand-operated vacuum suction to increase penile blood flow via distension of corporal sinusoids. This negative pressure subsequently induces arterial blood flow into the sinusoidal spaces of cavernosal tissues. Doppler studies have shown nearly a 2-fold increase in cavernosal artery diameter with use of VED.¹ Notably, VED can stimulate oxygenation of corpora without need for an intact nerve supply, a benefit vs pharmacological options for erectile dysfunction such as PDEi-5.

Mehr, J., Santarelli, S., Green, T. P., Beetz, J., Panuganti, S., & Wang, R. (2022). Emerging Roles of Penile Traction Therapy and Vacuum Erectile Devices. Sexual Medicine Reviews, 10(3), 421–433. https://doi.org/10.1016/j.sxmr.2021.12.003

Here's why they're safe:

The vacuum erection device (VED) is the oldest therapy used for male sexual function among all approved modalities. It was introduced for erectile dysfunction (ED) nearly 150 years ago, cleared by U.S. Food and Drug Administration in 1982 and adopted by American Urological Association (AUA) in 1996 as a standard of care.1 Significant amount of clinic evidence has proven the effectiveness of VED for ED since the early 1980s.

Wang, R. (2022). Is There Still a Role for Vacuum Erection Devices in Contemporary Sexual Medicine? The Journal of Sexual Medicine, 19(5), 682–685. https://doi.org/10.1016/j.jsxm.2022.02.013

Use a VED and show me how I'm wrong.

viewtopic.php?f=6&t=20455&hilit=here%27s+how+they+work[/quote]

[crazyjoe]

I lost about half an inch, but was able to recover it and then some with the Perito exercise and VED.

[Txagq8]

No VED.

Early activation & cycling. Lots of cycling for a full year.

Uneventful procedure & recovery.

Two weeks after surgery I was down by about 2”.

At the 3 year mark my LGX equipped cock is .06” shorter than where it started. That’s not a loss. That’s a measuring error. For real. The original measurement during consultation was in cm (17.3 cm = 6.81”) and my bathroom drawer ruler is in inches (6 3/4”)

Life is good.

The surgeon can’t put in what doesn’t fit, but a decent one should get you damned close to where you started.

[Hrc714]

With first implant I did not lose much. With my revision, I lost a lot of length. It was not a question of no erections causing atrophy. I went into surgery with an implant stuck partially inflated at 8.5”. I came out of surgery and still with 6.5”. Not sure why as revision implant was actually larger.

[newbie443]

From what I’ve been reading, I am under impression that implanting almost inevitably leads to loss of length.

Is that true? Anyone here who managed to recover to full length as it was prior to ED?

Actually ED cause size loss. There are very good publications on size loss in the documents worth reading thread in the general discussion section of this forum. Preventing and recovery of lost size from ED begins long before surgery. Doctor selection is important in this because many doctors don't seem to be as concerned about size loss. And you need to avoid those if possible. And if not you need to educate your self. The penis exercise document is a must read and explains this very well. And there are still many doctors that do not aggressively size during surgery. The LGX expansion will help with this but in cases of damage where the CX or Titan is the best choice you still need an experienced doctor with aggressive sizing to properly size a man. And there has also been seen a relationship in length of time waiting for activation and size loss. Again a doctor selection issue.

There is a lot more for you to research. Bottom line if you have ED you should be concerned about size loss. Read the penis exercise document. If you have diminished or no nocturnal erections you need to use VED penis exercise to prevent size loss. If you are late to this some size loss may not be recovered. Surgery can result in size loss. And aftercare may also. But this in many cases can be avoided with doctor selection.

Good luck going forward with this.

[SteveSW]

From what I’ve been reading, I am under impression that implanting almost inevitably leads to loss of length.

Is that true? Anyone here who managed to recover to full length as it was prior to ED?

Before Peyronie's and the resulting ED set in, I was pushing 7"and over time shrunk to 5.5", which is what I measured going into implant surgery. I measured the eact same length following surgery and have gained 3/4" of inch in the year afterwards. It's not quite the size I was in the good old days, but my dick is hard as a steel rod whenever, and forever how long I want it to be.

[misterecz]

There are several things you can do to avoid length loss:

- Choose a good surgeon [Eid, Clavell, Kramer, Hakky]
- Use a VED to avoid atrophy and increase implant size
- Use traction to increase implant size

https://pubmed.ncbi.nlm.nih.gov/21492409/

[Rider1400]

I was down an inch plus a little in length post implant at first pump. Had been rigorously using VED for 6 months prior. Gradually over 6 months of very consistent perito exercises I was back to within a 1/4” in length and actually a bit bigger in girth than ever remembered. Now at 7 plus months I’m fully back to my 7” length and plus a little in girth. Tried a VED after surgery but the way the Dr ran the tubes around the left side I can’t do it because it pinches the tubes and pulls them in toward my body causing pain so no going to try again. Extremely happy with implant!